Initial Relationship Therapy Consultation

In preparation for our forthcoming conversation, may I kindly invite you and your partner to complete the form below:

Your Full Name*

Your Partner's Full Name*

E‑mail*

Téléphone (optionnel)

Kindly share, in a few words if you wish, the key motivations or circumstances that have led you (or your partner) to explore this particular path of profound, personalised transformation. (This remains entirely optional and held in the strictest confidence to better attune our guidance to your unique journey.)*

Have either of you engaged with Iboga medicine in the past? (Should you wish to share any relevant details — format, setting, or reflections — please do so below. This remains wholly optional and confidential.)

Yes

Yes, both of us

Have either of you worked with sacred plants or shamanic therapies in the past? If so, please elaborate if you wish. Otherwise: None / Prefer not to say

Do you or your partner have any history of severe addiction or significant psychiatric conditions? If yes, kindly provide brief details should you feel comfortable doing so (this will help us ensure the safest and most appropriate support for your journey). If no, please simply indicate “None” or “Not applicable”.*

What budget range are you considering for a profound shamanic transformative accompaniment over several months?*

Under £3,500

Between £3,500 and £7,000

Between £7,000 and £12,000

To be determined / Open to discussion

Are you ready to make a meaningful investment in a profound and fully bespoke journey? (Range: £3,500 to £11,800, commensurate with the level of personalised guidance.)

Fully committed

Inclined, subject to details

Not presently

Once you have completed the form, you may reserve your preferred time slot here:

Proceed

Jadhe Diesse

Shaman, Transformational guide, founder of Shamans of Light — in service of your highest potential.

London, UK, New York, Los Angeles, Hong Kong, Caribbean, Geneva, Switzerland

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Iboga F.A.Q. - HIMA website

Iboga Health and Safety Guidelines - HIMA